Little screening for high risk users of opioids

March 7th, 2011

How much should a physician care about their patients risk of addiction when prescribing opiod drugs?

These drugs, all involving potential for not only of overdose, but of addiction and abuse, are inadequate monitored, according to a study at Albert Einstein College of Medicine of Yeshiva University recently published online at the Journal of General Internal Medicine.  The study found only loose monitoring among even patients who are at a high risk of misuse.

The results, 2.2 million Americans using painkillers recreationally for the first time during 2009.

“Our study,” says Joanna Starrels, assistant professor of medicine at Einstein, and lead author of the study, “highlights a missed opportunity for identifying and reducing misuse of prescribed opioids in primary care settings.  The finding that physicians did not increase precautions for patients at highest risk for opioid misuse should be a call for a standardized approach to monitoring.”

Of all patients prescribed opioid drugs, only 8% were given urinary drug tests, and only 24% of those at high risk.  But whats more disconcerting than this is the fact that those at a high risk were much more likely to receive multiple refills of the drugs.

The solution presented by the study was to standardize care for those receiving opioids, as well as scheduling multiple face to face appointments with these patients while not breaking from the scheduled refill plan.